Diagnosis and the Heal skill

[Ianuagonde]

After a fierce battle with Lycanthropes, the party healer tried to see which members were infected after being bitten. And we hit a wall. The Heal skill mentions treating disease, but not diagnosing disease. I went to the forums, of course, for guidance. The mighty Curmudgeon informed me that Heal cannot be used to diagnose specific diseases. Which led to

That's...unexpected. Well, if specific diseases cannot be identified, that makes me wonder...

Q34 Can the Heal skill be used to see if someone is sick, as in, suffering from a disease?

I keep picturing this sick peasant who goes to the doctor because he keeps taking Strength damage.
-"Please fill in this chart, and we'll have you on your feet in no time!"
-"Are any of your family Shadows? No...Are any of your friends Shadows? No...Do you swallow Lich Dust at least once a day? No...Do you come into contact with Dragon Bile, either professionally or at home? No...Have you been stabbed by a Purple Worm in the last 24 hours? No..."

I hope someone can clear this up. Can the Heal skill be used to see if someone has a disease? If not, how do you tell if someone has a disease?

[Cranthis]

The heal description in the PHB hints that it can, but I can't find a solid ruling.

[J-H]

Heal is basically Profession:Medic, so it should work for non-magical diseases.

Can you try using Detect Magic for magical diseases/poisons?

[Ashtagon]

At a D&D level of technology, Heal typically means applying poultices, bleeding with leeches, and maggot therapy (yes, really). A few of the more advanced therapies involve washing of hands, clean water, healthy food, and ensuring adequate fresh air.

Given the above, non-magical diagnosis doesn't really go beyond "yep, he's sick".

Medical science in medieval times was rather primitive, even by Neolithic standards.

EDIT: Now, if you want something playable...

Any character who wasn't bitten or clawed should be safe. Conventionally, lycanthropy is spread by saliva, although there's usually enough organic detritus under claws that a claw wound could be infected.

You can't actually diagnose an infection without symptoms. Modern medicene allows diagnosis before symptoms show, but that involves blood chemistry laboratories, which are only just barely within the realms of modern technology as field kits, and only for a limited variety of diseases. By medieval standards, no symptom means no diagnosis.

The one symptom that *might* show up is a slight fever and/or swelling around the wound site. However, that won't prove it is lycanthropy; it could be just a regular infected wound (eg septicaemia). This won't show up immediately in any case. A diagnosis may be possible from 24 hours after the fight and later. Call it DC (25 - disease's Fort save; more virulent diseases are easier to detect the presence of, because the produce a stronger reaction) to detect that there is a mild infection at that point. That DC to detect the presence of "an infection" should drop rapidly as you approach the first Fort save at which actual symptoms occur.

Once ability score points are lost, detecting "an infection" should be automatic. Realistic: Identifying what specific disease it is though, is pretty much impossible when medical science literally lacks the vocabulary to do this. Cinematic: Call it a DC = disease's Fort save to identify the specific disease once ability points start being lost (harsher diseases tend to be rarer, making specific diagnosis harder).

Based on folklore, the only way to diagnose lycanthropy is to see the person transform.

Any kind of magical detect disease spell should be able to identify the specific disease and possibly even treatment, unless it is a "GM special" whose cure is a plot point, even if symptoms (ability point loss, etc.) have yet to appear.

[mattie_p]

Incidentally, the Cure Disease spell referenced, despite being linked to D&D Wiki, is apparently a Level 0 orison for shamans found in Oriental Adventures.

Also, while herb poultices are not used now (although bandages often have various topical remedies embedded, some of which may be herbally based), leeches and maggots are still used medicinally.